Clifford A Massie, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071004962 Issued in IL

Practice address

800 Biesterfield Rd
Suite 510
Elk Grove Village, IL 60007-3361

Phone

(847) 981-3660

Fax

(847) 956-5108

NPI assigned

Oct 11, 2007

Last updated

Apr 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1356539621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3660",
            "fax_number": "847-956-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3660",
            "fax_number": "847-956-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIE",
        "first_name": "CLIFFORD",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071004962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sublung@380.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd",
            "address_2": "Suite 510",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Theresa Linn Martin
• Ewa Mascarenhas
• James R Mason, M.D.
• Daryl K Massey, PT, MPT
• Patrick B Massey, M.D, PHD
• Maria Denise Mataragas
• Megan Rose Mathiowetz
• Wanda Mazurek, M.D.
• Lori McCabe, BA
• Patrick L. McCarthy, M.D.

• Psychologist in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.